Introduction Oral health plays a crucial role in preventing hospital-acquired infections, particularly among critically ill patients admitted to Intensive Care Units (ICUs). In these environments, the oral cavity may act as a reservoir for pathogenic microorganisms capable of triggering systemic infections such as ventilator-associated pneumonia and sepsis. Objective This study aimed to analyze the available scientific evidence on the role of dentists in preventing hospital infections in ICU patients and to evaluate the impact of hospital dentistry interventions on clinical outcomes. Methods This scoping review was conducted based on a search of PubMed, SciELO, and Google Scholar databases, following the steps of identification, screening, and eligibility of studies. Titles, abstracts, and full texts were reviewed by two independent reviewers, with a third reviewer resolving disagreements. Ten studies were selected, ranging from observational evaluations to clinical trials and quasi-experimental studies, involving hospitalized adult, pediatric, and convalescent patients. Results The included studies showed that dental interventions were associated with reduced respiratory infections, especially ventilator-associated pneumonia, along with lower systemic complications and hospital mortality. Discussion The evidence highlights the importance of integrating dentists into multidisciplinary ICU teams to strengthen infection prevention strategies and improve patient safety through structured oral health protocols. Conclusion The inclusion of dentists in ICUs is essential for preventing hospital infections and improving clinical outcomes, reinforcing the need for standardized protocols, specialized training, and public policies supporting hospital dentistry.
Introduction/Background Periodontal diseases are long-term inflammatory diseases of the gingiva and alveolar bone that can result in the loss of teeth in the case of untreated conditions. Despite the fact that conventional smoking is an established risk factor, the widespread adoption of electronic cigarettes (e-cigarettes) has raised new concerns about periodontal health. Methods and Materials PubMed, Scopus, and Google Scholar were utilized for carrying out this narrative review. Keywords were e-cigarettes, vaping, electronic nicotine delivery systems, periodontal disease, periodontitis, oral microbiome, gingival inflammation, and oxidative stress. Publications up to February 2026 were considered, with systematic reviews and meta-analyses (2023–2025) prioritized. Evidence on clinical periodontal parameters, inflammatory biomarkers, and changes in the microbiome was synthesized. Results E-cigarette smoking is linked to elevated levels of gingival inflammation, oxidative stress, immune dysregulation, enrichment of inflammatory pathogens like Porphyromonas gingivalis and compromised tissue repair. Periodontal parameters tend to be poorer than in non-smokers but better than in traditional smokers, which demonstrates a moderate risk profile. Discussion E-cigarettes seem to be an intermediate risk factor of periodontal disease. The mechanisms involved are oxidative stress, cytotoxicity, neutrophil dysfunction and microbial dysbiosis, though usually at reduced intensity compared to traditional smoking. Nevertheless, the existing evidence is constrained by cross-sectional designs, brief follow-ups, and confounding variables, including multiple uses or prior smoking, which makes it challenging to reach logical conclusions regarding long-term effects. Conclusion Current evidence suggests that e-cigarette use is associated with adverse changes in periodontal health and should not be assumed to be biologically inert for oral tissues. Its long-term periodontal effects are not well understood, although it is not as harmful as combustible tobacco. More longitudinal research is required, and dental practitioners are advised to counsel patients on the dangers of vaping and ways of quitting.
Background The effect of autoclave sterilization on the fatigue life of modern heat-treated Nickel-Titanium (NiTi) files is debated. This study quantifies this effect on two contemporary file systems. Objective To evaluate the impact of 0, 1, and 2 autoclave cycles on the cyclic fatigue resistance of EdgeFile X7 (FireWire™) and Fanta File (AF-H Wire). Methods A total of 84 new files (25/.06, n=14 per subgroup) were tested. After autoclaving (134°C, 18 min), files were rotated at 300 RPM in a standardized steel canal (60° curve, 5mm radius) until fracture. The Number of Cycles to Failure (NCF) was calculated and analyzed using two-way ANOVA. Fractured surfaces were examined with Scanning Electron Microscopy (SEM). Results A significant interaction between file type and sterilization was found ( p < 0.001). EdgeFile had higher initial NCF (2649 ± 348) but showed a greater fatigue reduction after two cycles (38.6% loss). Fanta File had a lower initial NCF (1353 ± 168) but was more resistant to degradation (19.5% loss). Both file type ( p < 0.001) and sterilization ( p < 0.001) were significant factors. SEM confirmed fatigue failure in all samples. Discussion A significant interaction effect revealed that while EdgeFile X7 offers higher initial durability, its alloy is more susceptible to thermal degradation compared to the more stable Fanta File. Consequently, the cumulative damage induced by sterilization suggests that reuse protocols must be strictly limited to minimize the risk of intracanal fracture. Conclusion Autoclave sterilization significantly degrades the fatigue resistance of both systems, but the effect is material-dependent. The initially more durable EdgeFile was more susceptible to damage than the Fanta File. This data supports limiting the reuse of these instruments to ensure patient safety.
Introduction There is a growing number of dental students who are increasingly pursuing career opportunities abroad, and this area remains underexplored. This study aimed to examine the career choices and future plans of dental students in Jordan. Methods This cross-sectional study was conducted on dental students (N = 300) at various universities in Jordan in 2023-2024. Following ethical approval, a self-administered questionnaire was used to collect the information: dental students' career aspirations, motives for choosing dentistry, socioeconomic background, interest in dentistry, and projected career paths. The data were analyzed using SPSS 22. Results The study sample consisted of 192 females (64%) and 108 males (36%). A total of 153 students (51%) were enrolled in government universities, while 147 students (49%) attended private universities. Most of both female and male students reported that the decision was their own, with a notably higher number among females. Most students (200) expressed a desire to become specialists, a smaller number of students wished to become researchers, while even fewer were interested in becoming general dentists. Additionally, a small portion of students remain undecided about their future career path. A large portion, 159 students (53%), indicated that they have plans to pursue a clinical career; a significant portion, 93 students (31%), were undecided; and 48 students (16%) expressed plans not to become a clinical dentist. A total of 61 students (20.3%) expressed a preference for staying and working in Jordan after graduation. When considering international destinations, the USA was the most popular choice, with 30 students (23%) wanting to work there, followed by the UK with 24 students (18%). Discussion Through a comprehensive survey administered to dental students, this study also investigated various dimensions of their educational and professional lives, including their financial support for dental education, their interest in specialized fields of dentistry, and their plans for post-graduation. Furthermore, this study explored the potential implications of students' aspirations to work abroad and offers an analysis of how these trends might influence the country's dental education system and healthcare landscape. Conclusions Overall, personal motivation played the most significant role in the decision to pursue dentistry. The majority of the dental students are interested in working abroad in developed nations such as the USA, UK, Australia, Germany, Canada, and the Gulf nations. Most students expressed a desire to become specialists, a smaller number of students expressed their desire to become researchers, while even fewer were interested in becoming general dentists. Additionally, a small portion of students remained undecided about their future career path.
Introduction This study aimed to evaluate the effect of different surface conditioning protocols on the Shear Bond Strength (SBS) between SLA-based 3D-printed PMMA denture base and resin-based artificial teeth. Methods Forty denture base specimens were fabricated using stereolithography-based 3D printing and allocated into four groups (n = 10): control (unpolymerized resin-only), bonding agent, monomer + sandblasting, and monomer-only. The teeth were attached to the denture base specimens with the base resin monomer. SBS was measured using a universal testing machine. Failure modes were classified, and surface topographies were examined by Scanning Electron Microscopy (SEM). Statistical analyses were performed using Welch’s one-way ANOVA with Games-Howell post-hoc tests and Pearson’s chi-square test (α = 0.05). Results Significant differences in SBS were observed among the surface conditioning protocols ( p < 0.001). The monomer-only group exhibited the highest SBS values, followed by the sandblasting + monomer group, the control group, and the bonding agent group. Mixed failures, defined as fractures occurring both at the tooth-denture base interface and within the material, were predominantly observed in the monomer-only and sandblasting + monomer groups, whereas adhesive failures were more frequent in the bonding agent group. SEM analysis revealed distinct qualitative surface morphologies associated with each conditioning protocol, including smoother surfaces in the control group and more porous and irregular surface structures after monomer application. Discussion The higher SBS values observed after monomer application may be associated with improved interaction between the denture base resin and artificial teeth. In addition, the qualitative SEM observations suggested that differences in surface morphologies may have contributed to variations in interfacial adhesion among the tested groups. Conclusion Monomer application demonstrated the highest bond strength values among the evaluated surface conditioning protocols for bonding resin-based artificial teeth to SLA-based 3D-printed PMMA denture base resin.
Introduction This prospective observational split-mouth study aimed to compare the effect of self-ligating bracket type (active versus passive) on the extent of Orthodontically Induced Inflammatory Root Resorption (OIIRR) in maxillary first premolars during alignment, leveling, and initial torque expression in orthodontic treatment. Materials and Methods A split-mouth design was employed in 10 patients (7 females, 3 males; 20 maxillary first premolars). Each patient received simultaneous orthodontic treatment with active and passive self-ligating brackets. The right side was randomly assigned to active self-ligating brackets (Forestadent, Pforzheim, Germany), and the contralateral side to passive self-ligating brackets of the same manufacturer. After nine months, both premolars were extracted and analyzed using a 3D Confocal Laser Scanning Microscope (Lext OLS 4000, Olympus Corporation). Volumetric measurements of resorption craters (area, volume, and depth) were obtained with specialized software. Results No statistically significant differences were observed in the extent of external root resorption between active and passive self-ligating brackets. Both bracket systems showed comparable mean values for resorption area, volume, and depth. Discussion This study provides the first direct intra-patient comparison of active versus passive self-ligating brackets, eliminating inter-individual variability. Findings suggest that the biological response leading to OIIRR is comparable between both bracket systems, indicating that individual biological susceptibility may outweigh the mechanical differences in bracket clip design during the initial stages of treatment. Conclusion Passive and active self-ligating brackets produce comparable levels of orthodontically induced inflammatory root resorption during early stages of treatment. Orthodontic forces should be maintained at the lowest biologically acceptable levels to minimize iatrogenic effects.
Introduction Reducing the risk of bacterial colonization of dental materials can potentially decrease the need for systemic antibiotic therapies, thus minimizing the risks of antibiotic resistance and adverse drug reactions. Furthermore, the antimicrobial and anti-biofilm properties of these materials contribute to enhanced patient safety by lowering the likelihood of post-operative infections. The aim of this in vitro study was to investigate the effect of adding mesoporous silica nanoparticles containing silver on the safety, antimicrobial, and mechanical properties of glass ionomer cement.Materials and Methods Glass ionomer cement was mixed with mesoporous silica nanoparticles containing silver until completely blended. The MTT method was used to assess the safety of the material. The microbroth dilution method was used to investigate the antibacterial effect of the nanoparticles and determine the MIC and Minimum Bactericidal Concentration (MBC). The disk diffusion method was also used to evaluate the microbial activity of the nanoparticle-containing cements. For the solubility test, materials were prepared according to ISO 4049, and the dissolution test was performed. The Shapiro-Wilk test was used to assess the normality of the data. The t-test was used to compare the results between groups. GraphPad software was used to analyze the data. A probability value of less than 0.05 was considered significant.Results Significant differences were observed in the growth inhibition zones among the groups (p=0.001), with the cement containing 5% Nanoparticles Showing Superior Results Compared To Those With 3% (p=0.03) And 1% (p=0.01). Similarly, the Minimum Inhibitory Concentration (MIC) analysis revealed a notable difference between groups (p=0.0001), where the 5% nanoparticle cement outperformed the 3% (p=0.001) and 1% (p=0.02) formulations. For Minimum Bactericidal Concentration (MBC), the 5% nanoparticle group again demonstrated significantly better results (p=0.0001) compared to the 3% (p=0.001) and 1% (p=0.0001) groups. The Minimum Biofilm Inhibitory Concentration (MBIC) followed a similar trend (p=0.0001), with the 5% nanoparticle cement yielding better outcomes than the 3% (p=0.001) and 1% (p=0.0001) formulations. Solubility tests indicated no significant difference between cements with and without nanoparticles (p=0.4). However, water absorption measurements showed a significant increase in the nanoparticle-containing cement compared to the control (p=0.02). Lastly, flexural strength assessments found no statistically significant difference between nanoparticle-containing and nanoparticle-free cements (p=0.7).Discussion These findings highlight the potential of Ag-MSN-enriched GICs in clinical use, where antimicrobial effects are critical, such as in high-caries-risk patients or under crowns and bridges.Conclusion The findings of this study demonstrate that incorporating 5% nanoparticles into cement formulations significantly enhances their antimicrobial properties, as evidenced by improved growth inhibition zones, MIC, MBC, and MBIC values compared to lower nanoparticle concentrations (3% and 1%). While the inclusion of nanoparticles increases water absorption, it does not negatively affect the solubility or flexural strength of the cement. These results suggest that nanoparticle-enriched cement, particularly at a 5% concentration, holds potential for applications requiring enhanced antimicrobial activity without compromising structural integrity.
IntroductionAs Artificial Intelligence (AI) continues to transform patient care and the overall healthcare sector, assessing dentists’ awareness and utilization of these technologies is essential to understanding the current landscape of integration in dental practice in Saudi Arabia. MethodsA cross-sectional quantitative research was conducted, utilizing a structured, 37-item validated questionnaire, distributed to 375 practicing dentists in Saudi Arabia. Proportionate stratified sampling was employed to ensure that the sample size for each region (North, South, East, West, and Central) was proportional to its population relative to the total population. ResultsMajority of dentists (66.9%) are partially aware of the basic principles of AI, while 10.1% reported no awareness. AI Knowledge acquisition was primarily gained through self-learning, according to 38.4%. Dentists utilize AI mostly in research (15.92%); however, the main concern regarding AI integration, according to 31.5%, is cost. Statistically significant regional differences were observed in participants’ knowledge and experience (p = 0.017) and for perceptions and attitudes towards AI (p = 0.008). There were no significant differences based on other parameters such as age, gender, specialty, and employment history. DiscussionThe findings indicate moderate AI awareness among dentists, with most knowledge gained through self-learning and limited formal training. AI use remains primarily research-oriented, reflecting early integration stages and cost-related barriers. Significant regional variations suggest uneven access to AI resources and education, while demographic factors showed no notable influence. These results highlight the need for structured AI curricula and continuing education to enhance competency and promote equitable integration of AI technologies in dental practice across Saudi Arabia. ConclusionDentists' knowledge, application, perceptions, and attitudes toward AI in Saudi Arabia were generally consistent across factors such as age, gender, education level, specialty, occupation, and experience. However, significant regional differences were observed.
Introduction This in vitro study aimed to compare the failure patterns of two restorative techniques in severely damaged, endodontically treated maxillary central incisors: (1) endocrowns fabricated from lithium disilicate ceramic (IPS e.max Press), and (2) quartz-fiber posts with composite resin cores and lithium disilicate crowns (IPS e.max Press). Materials and Methods Twenty freshly extracted human maxillary central incisors with intact roots, comparable in length, morphology, and size, were selected. The teeth were randomly allocated into two groups (n = 10): Group I, restored with lithium disilicate endocrowns (IPS e.max Press), and Group II, restored with quartz-fiber posts, composite resin cores, and lithium disilicate crowns (IPS e.max Press). Specimens were mounted and tested using a universal testing machine. A compressive load was applied at a 45° angle to the middle third of the palatal surface at a crosshead speed of 0.5 mm/min until failure occurred. Failure patterns were recorded and analyzed using SPSS software (version 13). Results Statistical analysis revealed no significant differences in the distribution of failure patterns between the two groups ( p > 0.05, 95% confidence level). Discussion This study compared endocrowns and post-and-core restorations for endodontically treated maxillary central incisors. Both techniques showed comparable fracture resistance, with failure modes differing mainly in location and repairability. Endocrowns demonstrated favorable outcomes due to their minimally invasive design and improved stress distribution. These findings support endocrowns as a conservative alternative while confirming that both approaches can provide clinically acceptable performance. Conclusion Within the limitations of this in vitro study, endocrowns fabricated from lithium disilicate (IPS e.max Press) exhibited failure patterns comparable to those of the conventional technique involving quartz-fiber posts, composite cores, and lithium disilicate crowns when restoring severely compromised endodontically treated anterior teeth.
IntroductionIn patients with facial tissue loss, facial prostheses restore aesthetics and function. Nevertheless, Room-Temperature-Vulcanized (RTV) silicones exhibit poor clinical performance, including low tear strength and color stability. Clean/industrial-grade RTV silicone is a cheaper substitute for medical-grade silicone. This study evaluated the effects of nanosilica fillers and inherent pigmentation on the tear strength and color stability of RTV silicone. Materials and MethodsFifty P25 silicone samples were used that contained nanosilica (0%, 1%, 2%, 3%, 6%) and TiO2-impregnated Beauty by Lizzie Parra (BLP) foundation pigment. Tear strength was determined using a universal testing machine. Color stability was assessed under accelerated aging using the CIE Laboratory. Post hoc t-tests and one-way ANOVA were used (p-value < 0.05). ResultsThe tear strength was low, ranging from 18.984 kN/m (0%) to 6.446 kN/m (6%). The 2% nanosilica group was better than the 3% and 6% groups, as it remained clinically viable. The use of intrinsic pigments improved the color stability of the pigment/filler compared to controls. TiO2 and nanosilica were used to prevent UV and sebum discoloration. DiscussionThe study highlighted trade-offs between mechanical integrity and esthetics, corroborated by the previous studies on silica-elastomer interactions. Limitations included small sample sizes and processing variables. ConclusionMechanical durability of RTV silicone was enhanced by moderate 2 wt% nanosilica, whereas esthetics were maintained by intrinsic pigmentation. Optimization is suggested by filler surface modification and long-term clinical trials.
Introduction Dental implants in the anterior region represent a reliable and esthetically pleasing alternative to traditional bridges. Titanium abutments are considered the gold standard in implant dentistry; however, their use in esthetic zones often results in gray discoloration, particularly when combined with all-ceramic restorations or in patients with thin peri-implant tissues. Zirconia abutments have been proposed as an alternative to overcome these limitations. This study aimed to evaluate the effect of different abutment materials on the color change of lithium disilicate crowns through both in vitro and clinical assessment.Materials and Methods Thirty lithium disilicate crowns (IPS e.max CAD) of standardized central incisor form were fabricated and distributed equally among three groups: (1) titanium abutments, (2) zirconia abutments with a titanium base, and (3) titanium abutments coated with opaque material. Crowns were placed on the respective abutments with glycerin as an intermediate medium, and color change was measured using the Easy Shade device. Data were analyzed with the Kruskal-Wallis test due to non-normal distribution.Results Significant differences were observed among the groups. Lithium disilicate crowns supported by titanium abutments demonstrated clinically unacceptable color changes (Delta E = 9.7). Zirconia abutments with a titanium base produced color changes closely resembling natural dentition (Delta E = 6.1), while opaque-coated titanium abutments yielded clinically acceptable results (Delta E = 7.8).Discussion The results indicate that the abutment material significantly influences the final color of lithium disilicate crowns. Zirconia abutments effectively mask the underlying metallic hue due to their high radiopacity and light-scattering properties, while opaque coating provides a viable and more affordable alternative to mitigate the graying effect of titanium abutments.Conclusion Within the study limitations, zirconia abutments with titanium bases and opaque-coated titanium abutments are recommended over conventional titanium abutments in the anterior region to achieve superior esthetic outcomes with lithium disilicate crowns.Clinical Trial Registration Number This study is registered with the Research Registry under the identifying number: researchregistry11472, and the reference hyperlink is:
Introduction Post-and-core systems are essential for restoring root canal–treated teeth, especially when damaged by trauma or decay. Fiber-reinforced posts remain the clinical standard, but newer all-resin posts have been proposed as alternatives. However, there is limited evidence comparing their bond strength and failure modes at different post lengths. This in vitro study evaluated the effect of post material (fiber vs all-resin) and post length (10 mm vs 5 mm) on pull-out bond strength and classified failure modes in endodontically treated premolars. Methods Sixty extracted mandibular premolars were randomly divided into three groups (n = 20): Group A – fiber posts (10 mm); Group B – all-resin posts (10 mm); and Group C – all-resin posts (5 mm). Following standardized root canal treatment and post space preparation, posts were cemented using a dual-cure resin cement. Pull-out bond strength was tested using a universal testing machine at 0.5 mm/s. Failure modes were categorized, and representative samples were examined under Scanning Electron Microscopy (SEM). Data were analyzed using one-way ANOVA and Tukey’s post hoc test ( p < 0.05). Results Group B (10 mm all-resin posts) had the highest pull-out resistance, followed by Group A (10 mm fiber posts), while Group C (5 mm all-resin posts) demonstrated the lowest resistance. Statistically significant differences between Groups B and C, and between Groups A and C ( p < 0.05) were observed; no significant difference was found between Groups A and B. Post material or length did not significantly influence failure mode. Discussion The study showed that post material and length influence retention strength, with longer all-resin posts performing comparably to fiber posts. These findings suggest that 10 mm all-resin posts may provide a conservative alternative in clinical scenarios where fiber posts cannot be placed. However, resin posts of shorter length demonstrated insufficient retention, limiting their clinical applicability. Conclusion Fiber posts remain the standard and most accepted option for post-and-core restorations. However, 10 mm all-resin posts showed comparable pull-out bond strength and may be considered as a viable option for anatomically constrained cases. In contrast, 5 mm all-resin posts had significantly reduced retention and are not recommended in cases where the optimal retention is essential.
IntroductionEarly detection of periapical lesions is critical for timely clinical intervention. Artificial Intelligence (AI) technology, particularly deep learning models, offers a promising approach for identifying such lesions. This study systematically reviews the application of deep learning in detecting periapical lesions across three radiographic modalities: periapical radiography, panoramic radiography, and Cone-Beam Computed Tomography (CBCT). MethodsThis study employs a systematic literature review methodology, adhering to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to ensure methodological rigor and transparency. ResultsThe results of this study demonstrate that integrating AI with periapical, panoramic, and CBCT enhances diagnostic accuracy and efficiency in the detection of periapical lesions. DiscussionThe integration of artificial intelligence with panoramic, periapical, and CBCT imaging modalities significantly enhances the diagnostic accuracy and operational efficiency in identifying periapical lesions. ConclusionThis study found that AI performs better at evaluating mandibular periapical lesions than at evaluating maxillary periapical lesions. Furthermore, periapical radiography is more sensitive than panoramic radiography for detecting smaller periapical lesions, whereas CBCT provides the highest diagnostic accuracy for both periapical and odontogenic cystic lesions. The integration of AI with radiographic technologies shows significant potential to enhance diagnostic precision, optimize treatment planning, and improve patient outcomes in endodontic practice.
Introduction Denture tissue conditioners are frequently colonised by Candida albicans , leading to denture stomatitis, because conventional materials lack antifungal activity. Turmeric oil, rich in curcumin, exhibits antifungal activity. This study investigated the effect of turmeric oil on the antifungal activity and tensile strength of denture tissue conditioners. Methods The minimum inhibitory concentration (MIC) of turmeric oil against C. albicans was determined using a microbroth dilution assay with each concentration tested in triplicate. Tissue-conditioner samples were prepared with turmeric oil concentrations ranging from 2% to 20% (w/w). A 10% nystatin solution served as the positive control, and the unmodified tissue conditioner as the negative control. Antifungal activity was assessed by agar diffusion on days 1, 7, and 14, and tensile strength was measured using a universal testing machine. Statistical analyses included Friedman, Kruskal-Wallis, and Mann-Whitney U tests, with p < 0.05 considered significant. Results The MIC of turmeric oil against C. albicans was 12.5 µg/mL, with antifungal activity increasing at higher concentrations. On day 1, the 20% formulation produced inhibition zones comparable to those of nystatin (23.05 ± 0.12 mm versus 27.04 ± 0.11 mm; p = 0.001). Although antifungal activity persisted for 14 days, activity declined after day 7. Tensile strength in the 20% group rose significantly from 0.086 ± 0.013 MPa on day 1 to 0.191 ± 0.038 MPa on day 14 ( p = 0.001), in both control groups. Discussion Turmeric oil displayed stronger antifungal activity while maintaining acceptable tensile strength. However, its effectiveness declined over time, indicating that it may offer only short-term protection. As these findings are based on in vitro testing, clinical studies are required to assess the performance of this approach in clinical practice. Conclusion A denture tissue conditioner with 20% turmeric oil effectively inhibited C. albicans compared to nystatin. It also maintained good tensile strength, suggesting it could help reduce denture stomatitis.
Introduction Oral health is integral to person-centered Long-Term Care (LTC), with oral diseases linked to frailty, malnutrition, aspiration pneumonia, and reduced quality of life. Therefore, the study aimed to synthesize recent evidence on the burden of oral disease in LTC and key barriers, and to review existing interventions that support sustainable oral health integration. Methods This study is a narrative review of peer-reviewed literature from PubMed, Scopus, Web of Science, and Google Scholar that used terms related to “long-term care” and “oral health,” limited to English-language studies addressing epidemiology, practice, interventions, or policy in LTC settings. Results Across LTC facilities, residents exhibit high treatment needs, hyposalivation, and impaired oral function, including downstream associations with dysphagia, pneumonia, and poor health-related quality of life. Persistent barriers include low organizational priority, workforce and time constraints, limited staff training, and dementia-related care resistance. Promising strategies include professional oral health management programs, structured nursing-led protocols using practical screening tools ( e.g ., Oral Assessment Guide and Oral Health Assessment Tool), and interprofessional education ( e.g ., MOTIVATE). Discussion At the system level, embedding dental professionals and aligning financing with oral nutrition benefits are associated with improved functional outcomes and facility performance. Cohort data link dental care utilization to lower LTC costs. Conclusion Integrating oral health into LTC is feasible and beneficial but demands policy-supported models that combine routine assessment, reimbursed protocols, and sustained interprofessional training to improve function, nutrition, respiratory outcomes, and equity in care.
ObjectiveThis state-of-the-art review aims to consolidate current clinical knowledge, emerging technologies, and evolving applications of customized subperiosteal dental implants for jaw reconstruction in patients with severe atrophic jaws. BackgroundAlthough historically abandoned due to high failure rates, subperiosteal implants have re-emerged as a viable graftless solution, driven by advances in digital workflows, implant design, and biomaterial technology. MethodsA focused literature search was conducted in June 2025 using PubMed, Scopus, Web of Science, and Google Scholar to identify relevant case reports, case series, and reviews. As this is a narrative review, no quality assessment or meta-analysis was performed. ResultsContemporary subperiosteal implants, fabricated using CBCT, CAD/CAM, and 3D printing technologies, demonstrate excellent bone adaptation, favorable biomechanics, and 5-year survival rates exceeding 90%. However, the available evidence is primarily derived from low-to-moderate certainty sources. Recent innovations include the use of titanium or PEEK frameworks, bioactive surface modifications, and immediate loading protocols. Primary indications include Cawood–Howell class V–VIII atrophy, failed bone grafts, and medically compromised patients. Contraindications comprise poor oral hygiene and uncontrolled systemic disease. DiscussionCustomized subperiosteal implants are a promising graftless solution for severe atrophy; however, higher-level long-term evidence is still required to confirm their efficacy and safety. ConclusionCustomized subperiosteal implants represent a promising digital approach for the rehabilitation of complex atrophic jaws. While high-level evidence remains limited, this narrative review highlights their expanding clinical applications and identifies key areas requiring future systematic investigation.
Introduction / Background Immediate implant placement in the posterior mandible requires precise assessment of alveolar bone morphology due to proximity to the Inferior Alveolar Nerve (IAN) and variable cortical anatomy. Population-specific morphometric data for Vietnamese adults remain limited. Materials and Methods This preliminary cross-sectional study retrospectively analyzed 42 Cone-Beam Computed Tomography (CBCT) scans of Vietnamese adults. Virtual Straumann® implants were simulated at mandibular premolar and molar sites. Measurements included implant length, distance to the IAN, buccolingual and proximal bone thickness, mandibular cross-sectional morphology (Chan classification), and interradicular relationship (Chen classification). Statistical analyses were performed using t-tests, Mann–Whitney U tests, and one-way ANOVA. Results Mean implant lengths ranged from 15.07 ± 1.28 to 15.93 ± 1.68 mm. The second molar demonstrated the shortest mean distance to the IAN (0.06 ± 2.13 mm), with simulated canal encroachment in 23.8% of cases. Buccal bone thickness increased apically in molars, while lingual bone showed site-specific thinning. U-type mandibular morphology predominated (40–48%), and the septal interradicular relationship was most frequent (56–64%). Discussion Compared with Western populations, Vietnamese adults exhibited reduced IAN clearance and a higher prevalence of U-type mandibular morphology, resembling patterns reported in East Asian cohorts. These anatomical features explain the increased risk of neurovascular injury and cortical perforation during immediate implant placement in posterior mandibular sites. Conclusion Vietnamese adults exhibit population-specific mandibular morphology characterized by limited IAN clearance and frequent U-shaped cross-sections in the posterior regions. CBCT-guided virtual planning is essential for optimizing implant positioning and ensuring surgical safety.
Introduction In recent years, components of gingival crevicular fluid (GCF), including alkaline phosphatase (ALP), serotransferrin (TF), and vitamin D-binding protein (DBP), have attracted attention as biomarkers for determining stages of pubertal growth in orthodontic treatments. In this review article, we critically evaluated the reliability of biomarkers present in GCF for the accurate identification of the pubertal growth spurt. Materials and methods A systematic search of scientific sources was conducted in the PubMed, Web of Science, and Scopus databases. In this search, the relationship between biomarkers present in gingival crevicular fluid and key stages of skeletal development, particularly the mid-pubertal stages of jaw growth (CS3–CS4 stages in the CVM index), was examined. The main focus of this article was to determine the association of biomarkers such as ALP with specific maturation milestones in the cervical vertebrae. Results The results obtained from the literature search in this article showed that there is a significant association between the concentration of some GCF biomarkers and the peak growth velocity. Discussion If the obtained data are confirmed, it can be expected that the diagnostic accuracy and treatment timing in growth-modification-based orthodontic interventions will improve considerably. Conclusion This non-invasive diagnostic approach appears to have promising clinical potential. However, its current clinical application is limited due to heterogeneity in study methodologies. Standardized protocols need to be developed as a fundamental prerequisite for the reliable use of these biomarkers in routine orthodontic practice.
Introduction Oral health is an important indicator of child well-being. Childhood caries is frequent, may cause sequelae, and compromise the ability to eat, smile, and speak, as well as the child’s mental and social health. The Child Perceptions Questionnaire (CPQ8-10) assesses the impact of oral diseases on quality of life across four domains: 1) Oral symptoms; 2) Functional limitations; 3) Emotional well-being; and 4) Social well-being. This study evaluated children’s perceptions of oral health before and after an oral hygiene educational activity. Materials and Methods Eighty-five 8-year-old children from a public municipal school in São Paulo were included. They underwent clinical examinations using the dmft/DMFT indices and completed the CPQ8-10. The children participated in an interactive lecture on oral health with audiovisual resources, received an illustrated booklet, and were provided with a kit containing a toothbrush and fluoride toothpaste. After 3 months, both the CPQ8-10 and clinical examinations for dmft/DMFT indices were repeated. Results When comparing baseline and 3-month follow-up, no statistical difference was observed in clinical indices: the mean dmft was 1.38 and the mean DMFT was 0.06. However, the CPQ8-10 mean score showed a statistically significant reduction in the functional limitation domain, decreasing from 15.08 before the lecture to 12.09 after the lecture. Significant differences were also observed in items related to children’s self-perception of their oral condition. Discussion Few studies have conducted long-term follow-ups, and evidence from other reviews suggests that short-term oral health behavioural change interventions are not sustained in the long term unless changes in the social environment support the new behaviours; however, the clinical significance of these changes for public health remains uncertain. Further longitudinal studies are needed to investigate the long-term impact of untreated carious lesions and their consequences on children’s oral health-related quality of life, as well as to assess the effectiveness of school-based educational programmes, emphasising the need to implement new programmes in public schools to improve children's oral health. Conclusion The present study demonstrated that a school-based oral health educational intervention was capable of positively influencing children’s self-perceived oral health and oral health-related quality of life, even in the absence of measurable short-term changes in clinical caries indices.
Introduction This study aims to compare the cytotoxic effects of ethyl acetate and n-hexane extracts of Capsicum annuum L. on Cal27 oral cancer cell lines by examining caspase-3 expression. Materials and Methods This study used an in vitro experimental design with a post-test-only control group. Capsaicin in the ethyl acetate extract of Capsicum annuum was identified using Thin Layer Chromatography (TLC) with detection at UV 254 nm. Cytotoxicity was evaluated using the MTT assay, morphological assessment, and caspase-3 expression. Caspase-3 expression was quantified using qPCR with GAPDH, and relative expression was calculated by the 2^–ΔΔCt method. Statistical Analysis: Differences in caspase-3 expression between selected treatment groups were examined using paired two-sample t -tests, whereas overall variation among all groups was analyzed with one-way ANOVA. Bonferroni post hoc tests were applied in multiple comparisons. Statistical significance was defined as p < 0.05 and adjusted to p < 0.005 for multiple testing. Results Phytochemical testing confirmed the presence of capsaicin in the extract. TLC analysis on silica gel GF 254 using a toluene–ethyl acetate–formic acid (5:4:1 v/v/v) mobile phase showed a single blue-violet spot (Rf = 0.71) under UV 254 nm, consistent with the capsaicin standard. Both fractions reduced the viability of Cal 27 cells in a concentration-dependent manner. The n-hexane fraction showed stronger cytotoxic activity, with an IC 50 of 218.10 µg/mL, compared with 317.10 µg/mL for the ethyl acetate fraction. Morphological examination revealed features consistent with apoptosis, such as apoptotic body formation. Under certain conditions (medium-only, 2% DMSO, and 1 × IC 50 ), caspase-3 expression appeared slightly higher in the ethyl acetate fraction; however, these differences were not statistically significant ( p > 0.05). Although ANOVA indicated overall significance within the hexane-treated group ( p = 0.005), Bonferroni-corrected post hoc analysis did not find any significant pairwise differences. Discussion The stronger cytotoxic effect observed with the n-hexane fraction suggests that non-polar constituents may play a major role in suppressing Cal 27 cell proliferation. While both extracts produced morphological evidence of apoptosis, the lack of significant variation in caspase-3 expression shows that additional mechanisms may be involved. Variations in solvent polarity likely influenced the phytochemical profiles of the extracts and their biological activity. Conclusion Both n-hexane and ethyl acetate fractions of C. annuum exhibited cytotoxic effects on Cal 27 oral cancer cells and produced morphological changes consistent with apoptotic features; however, further studies are required to confirm the involvement of apoptotic pathways.
